How much rates vary
Facilitymedian $257 · 10th to 90th $44 to $1,318Professionalmedian $49 · 10th to 90th $33 to $63
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $7,079.46 | Facility | None | $1,412.54 | $4,466.84 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $60.26 Typical High $63.10 | Professional | None | $29.51 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $44.67 Typical High $47.86 | Professional | 54 · Surgery only | $32.36 | $44.67 | $47.86 |
BCBS Idaho Setting Facility Modifier None Typical Low $83.18 Median $398.11 Typical High $1,318.26 | Facility | None | $83.18 | $398.11 | $1,318.26 |
BCBS Idaho Setting Professional Modifier None Typical Low $41.69 Median $53.70 Typical High $67.61 | Professional | None | $41.69 | $53.70 | $67.61 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $44.67 Typical High $61.66 | Professional | 54 · Surgery only | $36.31 | $44.67 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $40.74 Typical High $46.77 | Professional | None | $23.44 | $40.74 | $46.77 |
Moda Health Setting Facility Modifier None Typical Low $27.54 Median $60.26 Typical High $5,495.41 | Facility | None | $27.54 | $60.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $48.98 Typical High $63.10 | Professional | None | $36.31 | $48.98 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $44.67 Typical High $47.86 | Professional | 54 · Surgery only | $32.36 | $44.67 | $47.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $57.54 | Facility | None | $43.65 | $43.65 | $57.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $72.44 | Professional | None | $38.02 | $50.12 | $72.44 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $50.12 | Professional | 54 · Surgery only | $47.86 | $47.86 | $50.12 |
Regence BlueShield Setting Professional Modifier None Typical Low $45.71 Median $53.70 Typical High $57.54 | Professional | None | $45.71 | $53.70 | $57.54 |
Select Health Setting Facility Modifier None Typical Low $27.54 Median $28.18 Typical High $1,071.52 | Facility | None | $27.54 | $28.18 | $1,071.52 |
Select Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $48.98 | Professional | None | $27.54 | $27.54 | $48.98 |
United Setting Facility Modifier None Typical Low $144.54 Median $363.08 Typical High $501.19 | Facility | None | $144.54 | $363.08 | $501.19 |
United Setting Professional Modifier None Typical Low $29.51 Median $38.90 Typical High $54.95 | Professional | None | $29.51 | $38.90 | $54.95 |
13 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $21.88 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $8.71 | $12.02 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $6.31 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.90 Typical High $6.76 | Professional | 55 · Aftercare only | $3.98 | $4.90 | $6.76 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $48.98 Median $58.88 Typical High $81.28 | Professional | 63 · Small infant | $48.98 | $58.88 | $81.28 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $36.31 Typical High $50.12 | Professional | 78 · Unplanned return to OR | $28.18 | $36.31 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $30.20 Typical High $31.62 | Professional | 52 · Reduced service | $21.88 | $30.20 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.02 Typical High $12.59 | Professional | 53 · Discontinued | $8.71 | $12.02 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $6.46 | $8.91 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $6.31 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.24 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $51.29 Typical High $53.70 | Professional | 78 · Unplanned return to OR | $51.29 | $51.29 | $53.70 |
Where Idaho sits
The same service costs 4.1 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 10th of 51
$50.12
AK $110NJ $26.92
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.